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Best Evidence Based Practice vs Best Emotional Intelligence Based Practice


I deliberately made the title a little bit more intriguing for click bait purposes. The reality of the matter is that the best practice IS an evidence based + emotional intelligence based approach.

To the right you can see a little graphic that I whipped up earlier. The first venn diagram is something you might have seen variations upon before, and I had the second diagram in mind to tie together a few of the topics I've covered on facebook in the past.

I had a post a while back about coaching strategies, and how I really think the importance of having a good coaching strategy can't be overlooked. Of course people need an effective training program, they need an appropriate nutrition strategy, but they need more than just that... and as far as I'm concerned it's not just "accountability" either.

What's also important is that people come into a program with some idea of how the training strategy works, some idea of how the nutrition strategy works, and that they're confident and enthusiastic to give it their best try. The coaching strategy in my opinion should be something that builds and increases those levels of confidence, enthusiasm, optimism and ambition, and in my opinion the outlook should be a positive one based on enjoying the challenge.

What should those strategies be based on, though? Refer to the first chart.

This is something else that appears to be often misunderstood.
  • Best Scientific Evidence will support whether something is necessary, beneficial, worthwhile, or otherwise. Note however that just because it might not be necessary to do something in a specific way, this alone is not always a reason not to do it that way. See the following point.
  • Professional Observation & Experience may influence how the coach feels is the best way to approach those necessary & beneficial aspects. For example; "in my experience with my clients, we seem to maintain better enthusiasm, better adherence, and therefore better results and altogether a more positive experience when we go about it this way". For this reason, anecdotal evidence is still valid in discussing what makes for best evidence based practice. For some reason this remains a point of contention.
  • Client's Needs & Goals obviously another crucial point that people seem to overlook. 

This applies to each individual aspect of the coaching strategy, and the coaching strategy as a whole. Otherwise... well, here's a flow chart that I made which I think is pretty cool, too:

Now... we could be talking about weight loss goals, athletic condition goals, whatever goals. And I do seem to write about weight loss a lot lately for a guy who doesn't really think weight is the thing we should be primarily focused on. Either way though, here's the thing; the purpose of these articles isn't to promote weight loss or to sell weight loss or whatever else.

The purpose is to protect people, right?

To protect people from the belief that there's some certain diet that they need to be on to lose weight, some certain choices of foods that they need to avoid or else they'll get fat, some reason they should have been able to stick to some awful dietary regime despite being hungry and miserable... and in specific reference to what is considered "evidence based" in online fitness & coaching cliques, to protect people from the idea that they can reasonably be expected to heavily and indefinitely restrict caloric intake to extreme levels of deficit, or that this would actually be conducive to best condition.

Particularly in the context described above, the term "evidence based" as been so abused over the past few years that is become virtually meaningless. Everyone thinks they're evidence based, no matter how little evidence there actually is that supports their position, no matter how much evidence refuting their position which they dismiss arbitrarily or simply refuse to acknowledge... some seem to think that simply by considering themselves "evidence based" people that they're automatically right about everything despite their total inability to provide a compelling argument in support of their opinion, or an intelligent thought on anything else, either.

Now, when you're talking about weight loss or you are talking about lean athletic condition... here are some facts I don't think you can dispute;
Individuals have been successful via a variety of approaches, but not by just one particular approach to the exclusion of all others.

Despite this, no approach that exists has a good track record of success, especially "long term" success in weight loss without weight regain.
In fact, according to the International Journal Of Obesity; “it is now well established that the more people engage in dieting, the more they gain weight in the long-term.”

So... everyone on social media is an expert on weight loss, but no one (well, relatively few people) is actually losing weight successfully. Everyone seems to want to 'splain what everyone else should be doing, and what every dietitian, nutritionist, GP & other health professional and their respective organisations should be recommending for weight loss.

Here's the thing; if there's no approach that exists with a proven track record of resulting in long term, sustained weight loss... arguing in favour of ANY approach is not being "evidence based" no matter how many times you use the phrase or how many links you drop.

The only argument on the subject that is evidence based is to point out the futility of attempting to force people en masse on to any dietary regime based on restriction, deprivation &/or the omission of any particular food choices.

Any evidence based approach should have a good outcome, but if you scroll back up a little to my beautiful flow chart, you'll see that somewhere in between "evidence based approach" and "best long term outcome" there's some unknown point at which it all breaks down and doesn't quite work out the way it is supposed to.

So, really the discussion isn't "Evidence Based vs Emotional Intelligence" so much as it should be about applying some emotional intelligence to an evidence based approach. Because as per the flow chart above, when you leave the emotional intelligence part out of your coaching strategy, all you're really heading for is a great big question mark.

Any form of intelligence seems to be in short supply amongst humans these days, but emotional intelligence might be the rarest form of all.
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Dieting And Weight Loss; It's Time To Face The Facts

Real talk though; we need to face the facts about dieting for weight loss.

On any specific approach over the long term, more people are unsuccessful than are successful. On all approaches combined, more people are unsuccessful than are successful. However... while successful outcomes are the minority, they are not exclusive to any specific approach.

What can we observe or logically conclude about what enables a person to be successful with any approach to dieting?

I suggest the following:
  • They enjoy & have an appetite for enough of the included choices of food that they are satiated, or at least that hunger levels are manageable.
  • Total energy intake is far enough below "an excessive" level that would preclude fat loss, but high enough to avoid or mitigate adaptive thermogenesis aka "starvation mode" in the common vernacular.
     
  • Ideally they're including a suitable amount of reasonably healthful and nutritious choices, but some famous "stunt diets" you may have read about prove it could be done on just potatoes, twinkies, macdonalds, ice cream & whey... whatever. None of which I would personally recommend but it demonstrates an important point.
  • The eating habits they adopt fit in with their lifestyle & circumstances, and they're able to stay enthusiastic and not gravitate back towards their old habits.
  • So their are any number of overly simple answers but the reality is that for most people, success is going to be something that you have to decide upon and keep working on, on an ongoing daily, weekly, monthly, seasonal, year in, year out basis. Therefore you want "the path of least resistance" in my opinion.

Now... people often attempt to 'splain to me that their personally prefered diet (usually LCHF) is "more satiating" and therefore preferable over brute force starvation approaches which work in theory but backfire long term due to the effects on metabolism.

You can refer to the above for what is wrong with this logic. It would be satiating IF you happen to enjoy enough of the foods that fit this eating style and happen to consume enough of them to meet that "adequate but not excessive" energy provision that results in weight loss without metabolic adaptation.

However if you DON'T happen to enjoy enough of those foods, then it actually does become a brute force deprivation based approach. I still don't really understand how people can be quite so low in emotional IQ that they can't grasp this concept.

ANYWAY let's wrap this up.

With the right guidance you could achieve that "adequate but not excessive, satisfied but not stuffed, weight loss without metabolic downgrade" eating pattern on ANY selection of foods without feeling afraid or guilty about ANY particular choices or needing to rule anything out (other than on specific medical grounds obviously).

That's what I teach people to do.
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Interrupted / Intermittent Energy Restriction Sports Nutrition Strategy

Brand new for 2018, a new variation on the Flexible Fueling system inspired by the recent MATADOR (Minimising Adaptive Thermogenesis And Deactivating Obesity Rebound) Study showing that greater weight loss results were achieved with a "two weeks on, two weeks off" approach to dieting compared to continuous energy restriction.

I want to try to skim over a couple of things that have been covered previously and get on to what's new. My Flexible Fueling approach (in fact, even before I started calling it Flexible Fueling) has always been about getting people OUT of that restrictive, further and further into deficit approach to IIFYM and getting them confidently enjoying a variety the delicious & nutritious foods that suit & appeal to them, to a total energy provision that is adequate, but not excessive.

Flexible Fueling Towards Intuitive Eating

I covered this in more detail recently, but suffice it to say that for many people it's enough just to get out of dieting, practice regular eating habits to ensure that they meet at least a conservative estimate of their minimum requirements, leaving a reasonable margin for error or variance so that they don't have to feel anxious about a social engagement where they may indulge a little... and to understand that as this is a conservative estimate of minimal requirements, before long they're likely to experience some hunger signals, which they should respond to accordingly with an increase to a more appropriate level of daily energy intake.

Flexible Fueling Towards Metabolic Capacity

My experience as a professional coach is that in the vast majority of cases, people's problems stem from attempting to restrict to an insufficient level of energy intake relative to their requirements. In the case of more experienced, more proficient, serious fitness enthusiasts and competitive athletes this is a serious problem. Particularly with a younger, taller, more active client with a more advanced level of prowess at training it is imperative to increase steadily towards a target representing the highest level of energy intake that can be put to good use and produce a benefit in terms of athletic performance and condition.

This does not mean a "bulk and cut" strategy.

Serious fitness enthusiasts and competitive athletes as described above have a high energy requirement and potentially massive capacity for energy flux AKA the amount of energy that could be expended or otherwise utilised. As you increase towards this amount, a leaner and more athletic condition will be the result.

If you've been following me for a while you'll know all of this already, and you'll know it's what I've been talking about for years and everyone else is slowly starting to catch up to, including a bunch of suck ass motherfuckers who've argued with me in the past. PROLONGED & EXCESSIVE LEVELS OF RESTRICTION CAN ONLY BACKFIRE AND CANNOT RESULT IN MAINTENANCE OF A LEAN ATHLETIC CONDITION. Rather, that sort of nonsense is only conducive to a regression in physical condition and the development of an eating disorder.

So much for the "skim". Let's cut to it.

The Flexible Fueling Punctuated Periodisation Protocol

What we're doing here is inspired by the MATADOR study, but it's a little different and also I don't like to have anything to do with the notion of "restriction", so I had to come up with a cool name of my own for this variation on the strategy.

Refer to the graphic below, and I'll explain how it works.



For the first two weeks, we start at the most conservative estimate of absolute minimum requirement. Often this is still more than the amounts people are attempting to work with when they come to me. I drew this as a curve, as we're likely to find that it does in fact turn out to be overly conservative and that we need to come a little higher, towards a more reasonable, more workable reflection of our minimum requirement.

For the next two weeks, we work to a conservative estimate of Metabolic Capacity.

In theory vs in practice.

In theory, so long as you're in caloric deficit your body will draw upon fat stores to make up the difference, right? And the further into deficit, the more fat loss, right? And if you're not seeing fat loss, you're not in deficit, right?

Bull. Shit.

Real quick... what a lot of these fucking imbeciles out there don't quite have the brain capacity to grasp is that there is a difference between for example a 90kg male aspiring body builder who has just done a "bulk" on say 3500 cals per day, and a female athlete on 1400 calories per day or an overweight mature age female with a decades long history of extreme crash dieting. The male could cut to 2500 calories and see fat loss due to being "in deficit" and may find at some point that he needs to cut further to keep leaning out. That's not how I'd do it because I'm smarter than that, but that's why they think "if you're in deficit you lose fat, when you're not losing fat cut further into deficit". The female athlete can't possibly cut any lower and should never have been instructed to cut that low to begin with, YOU GET ME?

So, in pursuit of your goals you need more than just "restrict, restrict further and keep on restricting indefinitely until you hate your fucken life". You need a system where you work to intelligently calculated targets, and assess your response to those targets until you find what feels right and works right for you, allowing you to enjoy life and enjoy your best and most sustainable results from training.

Assessing the response and revising the strategy.

In theory you should see fat loss and therefore weight loss in that two week period at minimal intake. Interestingly though, some people will not see weight loss at that phase, but will see fat loss during the next two weeks while working to higher intakes. In which case, the question is whether the period of restriction is unproductive or whether it is necessary as the fat loss is a response to coming out of deficit. There's only one way to find out. If the period of restriction proves unproductive then it makes sense to find the lowest productive level of intake and consider that the new minimum.

If there is no fat loss at either level, you may decide to repeat the period and give it a little longer to see if it kicks in. Or you may logically conclude that since you can't go any lower, and since a conservative estimate of the most you could benefit from didn't do the job, you can only conclude that intake is still not high enough and a further increase to a less conservative estimate is required, as indicated on the chart at Week 7 & 8. In fact... if fat loss is apparent I'd still be likely to conclude that our conservative estimate is indeed quite conservative and I'd be optimistic that an increase to a less conservative level will prove productive.

At the very worst if we do overshoot that maximum level of intake and see an increase in weight beyond what would be explained simply by having more food passing through the digestive system, we have two weeks back at minimal intakes just around the corner that will resolve that, and we know to set our higher target more conservatively next time.

More likely though especially in the younger, the taller, and especially the more active people with a higher level of athletic prowess, everything works out better than expected and by the third cycle of the strategy we're confident and enthusiastic to get more adventurous with our higher targets.

Beyond Twelve Weeks

Having worked to different levels we'll have learned what's the least we can expect to last a few days or a week on, what's the most we can currently put to use while producing a leaner condition, and what's the optimal level of fueling relative to our requirements. We can then make an educated decision how best to proceed, either eating intuitively in accordance with our new habits and the healthy appetite we've developed, or by working to an optimal target for an extended period, or by continuing with the Punctuated Periodisation Protocol.
It's about enjoying life, enjoying the intellectual stimulation of working to a strategy, enjoying the physical stimulation of training, and enjoying the best and most sustainable results in athletic performance and condition.

Of course... such a complex and convoluted approach is not for everyone, which is why Flexible Fueling works on a spectrum between the "towards intuitive" to the "towards capacity" approaches, with this being somewhere in between. And it goes without saying that there's only ONE person capable of coaching this approach. Other people calling themselves "IIFYM" or "Flexible Dieting" guys and girls can't even begin to grasp this stuff. They literally just think "keep eating less, you must be lying to me and eating more than you say you are" is what passes for coaching.

Update:

Here's the revised version of the graphic representation of the strategy.

Now, exactly how this plays out is likely to vary from each individual to the next, but road testing this myself and with some clients what I've found is that at a certain point (week 9 on this version of the graphic) you realise that while you could reduce back down to those conservative, minimal intake targets, it's not actually doing you any favours to do so. So rather than cut back to minimal, you merely reduce from "less conservative" back to "conservative".

Also I've added a column for Week 13 & 14, where having established where our true maximal level aka metabolic capacity is, we have a good feel for an optimal level which is just shy of maximum, where we maintain absolute best performance and condition indefinitely.
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The Latest On Weight Loss, According To Science And My Observations

As fate would have it, quite a few interesting articles regarding research related to weight loss have come out in the past few weeks since I posted my "why we  should probably all stop offering weight loss coaching" article of a few weeks ago.

Now, unfortunately the fact remains that long term success with weight loss goals is a statistically unlikely outcome. Therefore I suggest that anyone making any promises about weight loss with the inference of "guaranteed" results is at best overly optimistic or at worst a damn dirty liar. Certainly though there are people out there who've lost weight and kept it off... so if you have a weight loss goal, and let's quantify that and say you have a permanent weight loss goal, what you probably want to be concerned with is figuring out where your best chances of success lie, and with avoiding the mistakes that all the unsuccessful people are making.

First let's talk about exercise. You should be doing some resistance training.

This is probably not news to anyone who has followed my various social mediums for more than a few minutes by now.

Resistance training is one of the best things you can do for your health, whether you have a weight related goal or not. Reiterating about 5000 of my previous entries though, and this is important so make sure you're paying attention this time, the purpose of resistance training is a lot less to do with "burning calories" and a lot more to do with inspiring your body to take up and put more energy and resources to use in supporting lean mass, ideally at the expense of fat mass.

So it's not just that you expend energy while training (although you do, and that's good) but that your body has something productive to do with the balance of energy that remains.

And by the way for what it's worth, it absolutely IS possible to gain lean mass at the expense of fat mass, especially for beginners but also even in more experienced athletes and enthusiasts.

Q: What's a good resistance training program for a client who wants to lose weight?

Exercise selection and variations in programming obviously will vary between individuals, but generally speaking the best resistance training program for a client who wants to lose weight is the same program that you would give her if she didn't want to lose weight... subject to her levels of confidence and proficiency at exercise.

Where most people with a "weight loss" focus will screw this up is by messing with the program, adding stuff in, leaving rest periods out, performing the whole routine as a super set or a circuit, and so on, with the idea that they "need to burn more calories to lose weight". So there's an obvious mistake you should decide right now that you will resist the urge to commit in future.

A couple of related links on this point:

Just a little more on the many benefits of strength / resistance training:

I may have digressed a little so peruse those additional links at your leisure. The first one may be especially pertinent to many of the people reading this entry.

Back to the main point as per the included image above, diet is key but resistance training will facilitate the best and most consistent results.

Paradox: Diet is the key, but "diets" don't work.

Diet is a contentious topic.

On the one side of the fence you have the people who insist upon some variation of the "all they have to do is stop eating crap food, cut out carbs, cut out grains, and eat clean" theme, and on the other side of the fence you have the people who insist "all that matters is that they are in caloric deficit". However, according to the International Journal Of Obesity, “it is now well established that the more people engage in dieting, the more they gain weight in the long-term”. So with one or two very rare, very notable exceptions, both camps are full of idiots.

Now I covered an abundance of evidence in this weight loss bullshit busting master post (not to mention all the other master posts), a while back... so rather than being redundant and repeat myself again and again, let's skip to the new stuff. Suffice it to say though, it's NOT about "clean eating" and it IS about "calories in, calories out", but it is NOT about "less and less and less calories in, more and more and more calories out".

At a certain point with such approaches... whether by deliberate caloric restriction or by omission of energy dense food choices to the effect of caloric restriction... all you are doing is training the body to manage the workload, rather than to actually benefit from training. It may be more accurate to say that you are training the body to require that level of workload (expenditure) at that level of restriction (intake) just to maintain a heavier and fatter condition, and if those levels are unsustainable then weight gain / regain will occur. As would appear to fit with the observation quoted earlier.

Again though, this has been a contentious topic. The majority of the "calories in calories out" crowd until very recently have insisted that there is no way for the body to adapt to prolonged and excessive levels of caloric restriction so as to preclude weight loss. Rather they would insist "if people are in deficit they see fat loss, if they're not seeing fat loss they're lying to you about how much they eat". 

Now since the Biggest Loser Study a year or so back, people in that camp have begrudgingly admitted that the body WILL adapt to prolonged calorie deficit and this WILL preclude further fat loss, but have continued to insist that the answer to this is simply to restrict even further into deficit and/or increase expenditure further with additional exercise & activity. I did mention that I think most of them are complete fucking idiots, didn't I?

Anyway. Increasingly, more and more evidence suggests that while fat loss IS dependant upon being in caloric deficit, we must work to appropriate levels of deficit where an expectation of adherence is not unreasonable, and where we are still providing sufficient energy and resources to benefit from training, and we must not restrict indefinitely but rather adopt a strategy of working at periods closer to metabolic capacity and at periods working from a greater level of deficit.

So, really that's almost exactly what I have been talking about for years... isn't it? 

Here are some links to relevant evidence:
Now... the approaches in each of those studies are different, but collectively in my opinion they more than sufficiently refute the "further into deficit (aka less calories in) always results in greater fat loss" doctrine as pushed by far too many halfwitted CI/CO & IIFYM proponents. 

Practical application of this information:

As coaches, as overweight or obese people, and even as fitness enthusiasts of non excessive weights, we need to be aware of and appreciate the paradoxical nature of things. To wit; an energy deficit is required to facilitate fat loss, but prolonged and excessive levels of energy deficit are associated with a higher body fat percentage in athletes and with greater long term weight gain in the overweight and obese. It is similarly ironic that when changes in body weight are seen as the most (or only) important outcome of an exercise program, we tend to adopt less effective approaches due to being overly concerned with "burning calories" and we are less inclined to pursue and appreciate the many benefits of productive activity.

Regardless of whether we are overweight and obese people or whether we are relatively lean and more active people, we need to move away from a "dieting" mentality where we glorify or consider necessary the arbitrary restriction of food choices, or over restriction of energy intake. We need to cease associating the suppression or ignoring of our bodies' hunger signals with discipline, will power or other strength of character and these virtues with the attainment and maintenance of a lean and healthy physical condition.

Rather, we should take an interest in learning and practicing a productive and beneficial approach to exercise and activity. We should practice regular, consistent, structured and varied eating habits to an appropriate but not excessive total energy intake. As per the links above, there may be some evidence to support the practice of eating more earlier in the day and less later on... but I would suggest whatever meal and snack schedule each individual finds convenient, appealing and sustainable to achieve "appropriate but not excessive total energy intake" by default without being too concerned about occasional divergences.

This could simply be described as practicing self care and healthy habits, and this alone should prove conducive to better physical and emotional health as well as a leaner condition, whether actual weight changes occur or otherwise.

For those who are enthusiastic to work more strategically to maximise their potential to see the most significant and sustainable results, the process should involve periods of working closer to a "maintenance" level of intake representing metabolic capacity, and periods of working to a merely "adequate" level of intake which is at a significant deficit, but still suitable to a reasonable expectation of adherence, and to reap the benefits of training without resulting in comprised metabolic rate.

Please come and discuss this entry on my facebook page.
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The Evolution Of A Coaching Strategy & Training Philosophy

To the right of the screen is a pictorial representation of an idea that has been banging around inside my brain for a little while, trying to find it's way out.

As you can see, we have a Training Strategy and Fueling Strategy which are separate, but parallel to one another. You wrap the two of those up together and you begin to have what we call a Coaching Strategy.

Let's elaborate.

Your Training Strategy encompasses your exercise selection, your program split, your sets & reps strategy, your prescribed rest duration between sets, and so on. Here I'm only really talking about concepts related to resistance training... we may also choose to incorporate High Intensity Interval Training, Low Intensity Steady State cardio... running, rowing, cycling, swimming... the choices are endless.

Ideally though we make choices strategically and we put them together in away that makes sense in the context of the pursuit of our goals. Note that as obvious as this seems, a lot of people fail to really grasp the concept, as all they're really thinking is "to burn calories".

Similarly your Fueling Strategy should be inspired by more than just the idea that "it's good to eat clean", or that "you lose body fat while in a caloric deficit". I have approximately 8 million articles elaborating upon this point already so I'll leave it at that just this one time in order to move forward.

So, at this point we have the strategic training program, and we have an idea of our fueling requirements. When you put the two of those together and you start to consider "how can I facilitate confident, consistent, enthusiastic adherence", then you go beyond merely having a training & fueling strategy, and you begin to have an actual Coaching Strategy.

Again note that a lot of people fail to grasp this concept, even though in some cases they have branded themselves as coaches and charge others a hefty fee for instruction and advice that is impractical and ineffectual, and expectations that are unreasonable if not impossible.

Having a Coaching Strategy as we've described hopefully signifies that you actually have people's best interests and well being at heart. When you think a little more deeply about all of this, what you start to develop is an all encompassing, overall philosophy on training.

In my opinion.

We should see ourselves as fortunate to have the opportunity to pursue fitness and training related goals, for enjoyment and to enrich our lives. It can add a sense of direction to our lives at times when that may be lacking. It should compliment and better facilitate success in our other interests and other aspects of life, rather than detract from or come at the expense of them. The psychological aspects, effects and consequences of training should be seen as being of equal importance as the physiological, and in fact it should be considered that the best and most sustainable results in the latter can only be attained by prioritising the former.

Further, in my opinion.

As a coach your aim should be to provide the knowledge, the strategies and an overall outlook on training that facilitates permanent results via reasonable methods for those who are serious and enthusiastic.

As an athlete, serious fitness enthusiast or as a beginner who is serious about becoming more enthusiastic, you should be aware that any of these short term "transformation challenge" type of programs promising miraculous results via extreme and unsustainable approaches will be more conducive to failure, a worsened relationship with eating, with exercise, and a regression in condition over the long term. The people marketing them are well aware of this.

Practical application in real life?

Think about 99% of what you see in those stupid infographics and everything else you see on social media fitness pages. How to avoid trigger foods, how to manage your hunger and stick to your calorie deficit, how to burn more calories at exercise, and so on. A load of garbage.

Rather than being about trying to find ways to force strict adherence to a dietary regime, your outlook on training should be about finding a balance where you have confidence in your established habits and your ability to break from your established habits as necessary, while facilitating the successful pursuit of your training related goals, however modest or however ambitious they may be.

A strategic approach is about more than just burning calories and restricting intake. A philosophical approach is about more than just futile attempts to force adherence to what is neither reasonable nor advantageous via concepts such as will power, discipline, or accountability.
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